Does Zytiga cause PSA Flare?

[6357axbz]

At the end of an ADT holiday (PSA reaches pre-determined level) and one resumes zytiga/pred prior to getting a lupron injection is PSA Flare an issue?

[Magnus1964]

I am not a fan of intermittent ADT. That aside, you may be experiencing a "PSA bounce." When prostate cancer cells die they give off PSA giving a higher higher reading.

[6357axbz in reply to Magnus1964]

Yes, IADT is controversial. Unfortunately the data comparing IADT versus CADT is sketchy. Just that I Hussain trial. That didn’t take into consideration the use of zytiga, debulking and other treatment nuances.

[Jbooml]

zytiga does nothing to suppress testicular androgens.....or block any of the androgen receptive testostonergic bio pathways.....if anything you should be prepping with casodex.

Seems like faulty logic

[6357axbz in reply to Jbooml]

Yes, I wasn’t precise enough. I should have said, “prior to getting a lupron injection preceded by degaralix or Casodex”. In other words should one wait for one of those two options before re-starting zytiga?

[Jbooml in reply to 6357axbz]

I believe zytiga’s role, being a cytochrome inhibitor plays little role in causing‘ flaring’ PSA...by way of PC apoptosis. My view is zytiga is the back guard to the yoeman’s work supported by hormonal ADT....I think what’s important is how well the holiday went in terms of PC remergence. Did your PSA numbers creep up or suddenly spike?

[6357axbz in reply to Jbooml]

Still creeping. Just want to have a plan in place for when it reaches 2.0. When that happens I can immediately start zytiga/prednisone cause I have it. I’ll have to schedule for a degaralix or lupron shot.

[Hirsch in reply to Jbooml]

Abi works at 3 sites to block synthesis of testosterone. Testes. Adrenals. Tumor sites.

[Tall_Allen]

It can. Wait a couple of months before the PSA.

[6357axbz in reply to Tall_Allen]

????Should I not effort to avoid the flare? Doesn’t the flare mean the cancer is extra active?

[Tall_Allen]

The flare means cancer cells are dying.

[6357axbz in reply to Tall_Allen]

So there really is no need to do anything to avoid it.

[immunity1]

Many suggest that PSA could be caused by PSA release from lysed cells. However, the aberrant activation of the androgen receptor or the transactivation of the androgen receptor induced by corticosteroids have been suggested as the possible cause responsible for PSA flare-up during systemic therapy Due to GNRH agonists, abiraterone or docetaxel. Other explanations are related to cellular heterogeneity and diversity in terms of drug sensitivity, cell cycle kinetics, and PSA expression. In any case, PSA flare early in treatment generally should not be the reason for stopping it. R